NPIMap

Organization Active NPI

The Psych Garden LLC

  • Psychologist
  • Belmont, MA
National Provider Identifier
1922578855
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
THE PSYCH GARDEN LLC
Practice address
25 Flanders Road
Belmont, MA 02478
Phone
(857) 598-2808
Fax
(857) 598-2864
NPI assigned
Dec 4, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Green, M.D.NPI 1407075294
Title
Owner
Phone
(857) 598-2808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X

Addresses

Primary practice location

25 Flanders Road
Belmont, MA 02478

Mailing address

25 Flanders Road
Belmont, MA 02478
Phone (857) 598-2808

National Provider Directory

National Provider Directory

Locations

25 Flanders Rd
Belmont, MA 02478
Phone (857) 598-2808

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1922578855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 FLANDERS ROAD",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "02478",
            "telephone_number": "857-598-2808",
            "fax_number": "857-598-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 FLANDERS ROAD",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "02478",
            "telephone_number": "857-598-2808",
            "fax_number": "857-598-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PSYCH GARDEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "857-598-2808",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.